Prosthesis removal cutting guide, cutting tool and method

Abstract

A kit for removal of bone adjacent to an implanted prosthesis. The kit includes a guide for cooperation with the prosthesis and a tool constrainable by the guide for removal of the bone. The guide may include a first portion of the guide that is co-operable with the tool and a second portion of the guide that is co-operable with the prosthesis.

1. A method of removing an implanted prosthesis comprising:
 incising a patient to expose a prosthesis implanted in a bone of the patient; 
 attaching a guide to the exposed prosthesis, the guide including a coupling portion and a guide portion, the guide portion including a first bone facing surface that defines a first slot, the attachment of the guide to the exposed prosthesis including attaching the coupling portion of the guide to the prosthesis such that the first bone facing surface of the guide portion of the guide faces a first surface portion of the bone adjacent to the prosthesis with the first slot spaced from an outer surface of the prosthesis; 
 moving a cutting tool into the first slot in the guide portion of the guide; 
 moving a cutting portion of the cutting tool through the first bone facing surface from the first slot; 
 contacting the first surface portion of the bone adjacent to the prosthesis with the cutting portion at a location in the first surface portion spaced from the outer surface of the prosthesis; 
 removing a portion of the bone adjacent to the prosthesis by moving the cutting portion through the bone at least partially about the periphery of the prosthesis spaced from the outer surface of the prosthesis; and 
 removing the prosthesis from the bone. 
 
     
     
       2. The method of  claim 1 , further comprising:
 mating a protuberance on the coupling portion of the guide with an orientation feature on the prosthesis prior to contacting the first surface portion of the bone. 
 
     
     
       3. The method of  claim 1 , wherein contacting the first surface portion of the bone comprises:
 plunging a tip portion of the cutting portion into the bone. 
 
     
     
       4. The method of  claim 3 , further comprising:
 contacting the bone with a side cutting portion of the cutting portion by moving the cutting tool along the first slot. 
 
     
     
       5. The method of  claim 4 , wherein contacting the bone with a side cutting portion of the cutting tool comprises:
 moving the cutting tool in an arcuate path along the first slot. 
 
     
     
       6. The method of  claim 1 , further comprising:
 withdrawing the cutting portion through the first slot; 
 moving the cutting portion into a second slot defined by a second bone facing surface in the guide portion of the guide generally opposite the first bone facing surface, wherein the second slot is not contiguous with the first slot; 
 moving the cutting portion through the second bone facing surface from the second slot; and 
 contacting a second surface portion of the bone adjacent to the prosthesis with the cutting portion by moving the cutting portion through the second bone facing surface from the second slot. 
 
     
     
       7. The method of  claim 6 , wherein contacting the second surface portion of the bone adjacent to the prosthesis with the cutting portion by moving the cutting portion through the second bone facing surface from the second slot comprises:
 contacting the second surface portion of the bone adjacent to the prosthesis with the cutting portion at an angle with respect to a longitudinal axis of the prosthesis different than the angle with respect to the longitudinal axis of the prosthesis at which the first surface portion of the bone adjacent to the prosthesis was contacted by moving the cutting portion through the first bone facing surface of the guide from the first slot. 
 
     
     
       8. The method of  claim 1 , wherein contacting the first surface portion of the bone adjacent to the prosthesis with the cutting portion by moving the cutting portion through the first bone facing surface from the first slot comprises:
 rotatably contacting the first surface portion of the bone adjacent to the prosthesis. 
 
     
     
       9. The method of  claim 1 , wherein removing a portion of the bone adjacent to the prosthesis comprises:
 creating a gap between the portion of the bone adjacent the prosthesis and an outer periphery of a cortical bone portion of the bone. 
 
     
     
       10. The method of  claim 1 , wherein removing a portion of the bone comprises:
 removing a portion of the bone adjacent to the prosthesis by moving the cutting portion along the first slot in a pattern which corresponds to the outer periphery of the prosthesis. 
 
     
     
       11. The method of  claim 1 , wherein the prosthesis includes a cavity which defines an internal surface, and wherein attaching the guide portion of the guide to the prosthesis includes:
 positioning the coupling portion of the guide in contact with the internal surface.